Medical management of congenital nasolacrimal duct obstruction.

Fifty-five infants were diagnosed to have nasolacrimal duct obstruction by an ophthalmologist prior to three months of age. All were followed prospectively, primarily with medical management. Seven were treated surgically. In the 55 infants, there were 62 obstructed nasolacrimal ducts. Eighty-nine percent (55/62) of the nasolacrimal ducts were opened with medical management only in the first sixteen months of life. Of the nasolacrimal ducts that opened spontaneously, 15% (8/55) were open at three months, 45% (25/55) were open at six months, 71% (39/55) were open at nine months, and 93% (51/55) were open at one year. Based on this data one can advise the parents of infants with nasolacrimal duction what the odds of remission are without surgery by the twelfth month of age. Of the infants obstructed at three months of age, 80% were clear by the twelfth month. Of the infants obstructed at six months, 70% were clear by the twelfth month and of those still obstructed at nine months, 52% were clear by the twelfth month.